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Limb Swelling (Lymphedema)

The lymphatic system is part of the body’s circulation and immune system. Lymphedema occurs when there is damage or blockage in the lymphatic system, causing swelling (edema) in the affected area. Lymphedema usually affects an arm or leg, but it can also affect other parts of the body, such as the head and neck. Swelling usually develops slowly, over time. It may develop during treatment or it may start years after treatment.

  

Causes of Lymphedema

  • Tumours or growths that block lymph vessels
  • Removal or damage to lymph nodes or vessels from surgery, and / or radiation therapy

  

What you need to look out for

Lymphedema can be treated but results are best if done early. It is important to look out for the following symptoms and if present, to see your doctor or nurse to be assessed.

  • Swelling that is soft to touch
  • Heavy or achy feeling around the area
  • Difficulty with movement
  • Itch, redness, warmth, thickening or hardening of the skin
  • Recurring skin infections

  



How it can be treated

Although there is currently no cure for lymphedema, it can be managed with early diagnosis and treatment. Your doctor or nurse will first need to assess your condition and arrange for tests if necessary. They may then refer you to see a Physical or Occupational therapist, who teaches you exercises and self-massages, or recommends special compressive garments (e.g. stockings, arm sleeves) to help you manage the lymphedema.

  

What you can do

The following are some of the do’s and don’ts to help you manage lymphedema and prevent further complications:

  • Elevate affected limb when resting, where possible​
  • Maintain a healthy body weight to reduce the strain on your lymphatic system
  • Continue your daily activities with exercises (e.g. yoga, walking) as tolerated. However, if the affected area is painful or sore at any point during these activities, stop them immediately
  • Keep nails and skin clean and dry to prevent infection
  • Wear special garments according to your therapist’s recommendations
  • Consult your therapist if you are going on flights ≥4 hours or altitudes ≥1500m, as high altitudes and low air pressure may lead to lymphedema. Your therapist will be able to advise you on the use of a customized gradient compression garment to be worn at all times during the flight
  • Clean all wounds or broken skin over the swollen area properly. Please seek medical attention immediately if the wound appears red, or feels warm or painful
  • ​Avoid intense or strenuous activities using the affected limb or area
  • Avoid exposure to strong sunlight and use sunscreen whenever possible
  • Avoid heat or hot water to the affected area, as high temperatures will increase the production of lymphatic fluid and worsen swelling
  • Avoid blood pressure measurements and any form of invasive treatments (e.g. blood withdrawals, injections, acupuncture) to the area
  • Avoid constricting the affected area (e.g. wearing tight clothing or accessories like watches, bracelets, rings)


When to call your cancer care team

Please inform your doctor or nurse as soon as you notice symptoms of lymphedema or if you develop the following symptoms that may indicate worsening or complications of the condition.

  • Redness, warmth or pain over the area of lymphedema which may indicate infection
  • Worsening swelling or pain on movement of the affected area

If you have any questions regarding the above, please call the Cancer Helpline at +65 6225 5655 or approach your doctor or nurse for further details.

The above contents have been approved by the Cancer Education Information Service, National Cancer Centre Singapore (NCCS), for people with cancer and their families and caregivers.